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Guan Y, Ma Q, Zhang Y, Zhao J, Guo X. Thyroid Metastases from Breast Cancer Case Report and Literature Review. Curr Cancer Drug Targets 2025; 25:83-95. [PMID: 38409692 DOI: 10.2174/0115680096274465240129055950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/08/2024] [Accepted: 01/19/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Thyroid metastasis arising from primary breast cancer is a rare phenomenon, with only a handful of cases documented in both national and international literature. The management approach and prognosis of this occurrence have sparked debates and uncertainties. CASE PRESENTATION Herein, we report the case of a 55-year-old woman with breast cancer. She previously underwent extensive excision of the breast lesion with adjuvant chemotherapy and endocrine therapy. After 9 years, she presented with neck discomfort and examination suggested right thyroid metastasis and lymph node metastasis in the neck. Imaging showed pulmonary and bone metastases. Furthermore, the patient received endocrine therapy. After 7 months of follow- up, the patient survived without any new distant metastases. Thyroid metastases originating from breast cancer often unfold with a subtle, intricate nature, making early detection challenging. They tend to emerge inconspicuously, intertwining with widespread systemic metastases, hinting at a less favorable prognosis. CONCLUSION Given the unusual clinical indicators, identifying heterochronic thyroid metastases in patients with tumors poses a distinct challenge, requiring clinicians to navigate the follow-up process with heightened sensitivity. The key lies in timely detection and early intervention, factors that can significantly enhance the overall quality of life for patients.
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Affiliation(s)
- Yumei Guan
- Breast Disease Diagnosis and Treatment Center, Affiliated Cancer Hospital of Qinghai University, Xining, China
| | - Qinjun Ma
- Pathology Department, Affiliated Cancer Hospital of Qinghai University, Xining, China
| | - Yiqing Zhang
- Pathology Department, Affiliated Cancer Hospital of Qinghai University, Xining, China
| | - Jiuda Zhao
- Breast Disease Diagnosis and Treatment Center, Affiliated Cancer Hospital of Qinghai University, Xining, China
| | - Xinjian Guo
- Pathology Department, Affiliated Cancer Hospital of Qinghai University, Xining, China
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2
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Sun Y, Wan B, Liu X, Dong J, Yin S, Wu Y. Breast cancer and neoplasms of the thyroid gland: a bidirectional two-sample Mendelian randomization study. Front Oncol 2024; 14:1422009. [PMID: 39469634 PMCID: PMC11513776 DOI: 10.3389/fonc.2024.1422009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 09/30/2024] [Indexed: 10/30/2024] Open
Abstract
Background With the rising incidence of breast cancer (BC) and neoplasms of the thyroid gland, a potential link between the two has drawn increasing attention. However, the causal relationship remains unclear due to various confounding factors. This study aims to investigate the causality between BC and thyroid tumors using Mendelian Randomization (MR) analysis. Methods We conducted a bidirectional two-sample MR analysis, utilizing breast cancer-associated single nucleotide polymorphisms (SNPs) from the Breast Cancer Association Consortium (BCAC) and thyroid tumor-related SNPs from the FinnGen (https://www.finngen.fi/) database. First, we performed univariable MR (UVMR) to assess the causal relationship between BC and both malignant and benign thyroid tumors, followed by reverse causality analysis. To account for potential confounders, we applied multivariable MR (MVMR). The inverse-variance weighted (IVW) method was primarily used, with secondary analyses performed using the weighted median and MR-Egger regression approaches. Results UVMR analysis revealed a significant positive causal relationship between BC and malignant thyroid tumors (odds ratio [OR] and 95% confidence interval [CI]: 1.291, 1.143-1.458, P = 3.90×10-5). No causal relationship was found between BC and benign thyroid tumors. The MVMR analysis, adjusting for confounding factors such as smoking, drinking, and body mass index (BMI), confirmed the robustness of the results. Conclusion This study provides genetic evidence supporting a causal relationship between BC and malignant thyroid tumors. These findings highlight the importance of thyroid cancer screening in BC patients. However, further MR studies or randomized controlled trials (RCTs) are necessary to assess small effects accurately.
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Affiliation(s)
- Yiqi Sun
- Department of Pathology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Bohan Wan
- Department of Pathology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xin Liu
- Department of Pathology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jianguo Dong
- Department of Pathology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Shengjie Yin
- Department of Medical Oncology, Municipal Hospital of Chifeng, Chifeng, Inner Mongolia, China
| | - Yiqi Wu
- Department of Pathology, Harbin Medical University, Harbin, Heilongjiang, China
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Patrizio A, Ferrari SM, Stoppini G, Palmisano E, Elia G, Ragusa F, Paparo SR, Balestri E, Mazzi V, Botrini C, Proietti A, Famà F, Benvenga S, Antonelli A, Fallahi P. Thyroid Metastasis from Primary Breast Cancer. J Clin Med 2023; 12:jcm12072709. [PMID: 37048792 PMCID: PMC10095414 DOI: 10.3390/jcm12072709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Breast cancer (BC), the most commonly diagnosed malignancy, frequently metastasizes to the bone, lungs, brain and liver at advanced stages, whereas the thyroid gland represents a rare target site for secondary disease. We examined the most recent literature about thyroid metastasis (TM) from BC after we encountered a peculiar case of a 71-year-old woman who developed sudden dysphagia, severe hypothyroidism and hypoparathyroidism due to TM 18 years after the diagnosis of her primary cancer. Based on published data, the prevalence of TM in BC ranges from 3% to 34%, with a median onset time of 48.2 months, although longer time intervals are not infrequent. TM negatively impacts the prognosis of these patients, however thyroid surgery can limit the local disease burden. Therefore, we suggest that clinicians involved in the follow-up care of BC patients should consider a differential diagnosis of secondary thyroid malignancy when incidental lesions are diagnosed during radiological evaluations or local symptoms affect the cervical region, even many years after the diagnosis of the primary cancer.
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Affiliation(s)
- Armando Patrizio
- Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, 56124 Pisa, Italy
| | | | - Giulio Stoppini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Elena Palmisano
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Giusy Elia
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Francesca Ragusa
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Sabrina Rosaria Paparo
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Eugenia Balestri
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Valeria Mazzi
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Chiara Botrini
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Agnese Proietti
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Fausto Famà
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital “G. Martino”, 98125 Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
- Master Program on Childhood, Adolescent and Women’s Endocrine Health, University of Messina, 98125 Messina, Italy
- Interdepartmental Program of Molecular and Clinical Endocrinology and Women’s Endocrine Health, Azienda Ospedaliera Universitaria Policlinico “G. Martino”, 98125 Messina, Italy
| | - Alessandro Antonelli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, 56126 Pisa, Italy
| | - Poupak Fallahi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
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Zhang K, Yu Y, Zang Y, Xu H, Lv B, Wang Q. Case report: Unique ultrasound feature of thyroid metastases in occult breast cancer. Front Oncol 2022; 12:970286. [PMID: 36263230 PMCID: PMC9575947 DOI: 10.3389/fonc.2022.970286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Occult breast cancer is an uncommon type of breast cancer. Metastases of occult breast cancer to other tissues are rather rare. We present a rare case of thyroid metastases in a 46-year-old woman who underwent occult breast cancer. The first ultrasound (US) examination of the thyroid showed that the left lobe was enlarged but had normal thyroid function. At first, this case was misdiagnosed as thyroiditis based on the thyroid US features. However, the cytological and histological results showed that nests of the neoplastic cells were found. Further immunohistochemistry results confirmed that these neoplasms were derived from breast tissue. Analysis using the successive US scans revealed that the sizes and echo of the thyroid repeatedly changed after the radiotherapy and chemotherapy treatment. To our knowledge, this is the first reported case of occult breast carcinoma presenting with thyroid metastases. This case can easily be misdiagnosed as thyroiditis due to the metastasis area not manifesting as regular suspicious nodules or diffused punctate calcifications.
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Affiliation(s)
- Kaining Zhang
- Department of Ultrasound, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Ultrasound, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Yong Yu
- Department of Ultrasound, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Ultrasound, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
| | - Yichen Zang
- Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hua Xu
- Department of Infectious and Endemic Disease Control, Shizhong District Center for Disease Control and Prevention, Jinan, China
| | - Beibei Lv
- Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Qian Wang
- Department of Ultrasound, Shandong Provincial Hospital, Shandong University, Jinan, China
- Department of Ultrasound, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Qian Wang,
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Tang Z, Gao L, Wang X, Zhang J, Zhan W, Zhou W. Metastases to the thyroid gland: ultrasonographic findings and diagnostic value of fine-needle aspiration cytology. Front Oncol 2022; 12:939965. [PMID: 35992787 PMCID: PMC9381705 DOI: 10.3389/fonc.2022.939965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction In the present study, we aimed to analyze ultrasonographic findings of metastases to the thyroid and explore the role of fine-needle aspiration cytology (FNAC) in the diagnosis of metastases to the thyroid. Methods Twelve cases of cytologically or/and pathologically confirmed metastatic tumors of the thyroid gland were reviewed. All the primary thyroid lesions and lymphomas were excluded. The location, maximum size, echogenicity, shape, margin, presence of calcifications, vascularity, and cervical lymph nodes were assessed on ultrasonography. In addition, the results of cytology or pathology (or both) were noted retrospectively. Results Eight of 10 patients were diagnosed correctly with FNAC. Two cases presented with diffuse involvement in both thyroid lobes. Nine cases demonstrated a hypoechoic nodule with an irregular margin, four of which had microcalcifications. One case presented with a mixed solid and cystic mass with an oval shape. The lesions with cervical lymph nodes were found in seven cases. Conclusion Most metastatic thyroid cancer has similar ultrasound features to primary thyroid cancer. In some cases with atypical US features, ultrasound diagnosis should be combined with the medical history. FNAC might be helpful in the diagnosis.
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Affiliation(s)
- Zhenyun Tang
- Department of Ultrasound Diagnosis, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Lili Gao
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Xue Wang
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Jingwen Zhang
- Department of Ultrasound Diagnosis, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Weiwei Zhan
- Department of Ultrasound Diagnosis, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
- *Correspondence: Weiwei Zhan, ; Wei Zhou,
| | - Wei Zhou
- Department of Ultrasound Diagnosis, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China
- *Correspondence: Weiwei Zhan, ; Wei Zhou,
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Tang Q, Wang Z. Metastases to the Thyroid Gland: What Can We Do? Cancers (Basel) 2022; 14:cancers14123017. [PMID: 35740683 PMCID: PMC9221047 DOI: 10.3390/cancers14123017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/12/2022] [Accepted: 06/16/2022] [Indexed: 02/01/2023] Open
Abstract
Metastases to the thyroid gland arise from other malignant tumors such as renal cell carcinoma, colorectal cancer, lung cancer, and breast cancer. In clinical practice, the incidence is low, and the symptoms are not specific, so it is often missed and misdiagnosed. It is finally diagnosed via the comprehensive application of many diagnostic methods, such as ultrasound, fine-needle aspiration biopsy, and immunohistochemistry analysis. Surgery-based comprehensive treatment is often adopted, but because it is usually in the late stage of the primary tumor, the prognosis is poor. In order to better understand the related characteristics of thyroid metastatic cancer and then improve the clinical diagnosis and treatment and the prognosis of patients, in this paper, we systematically summarize the research status of thyroid metastatic cancer.
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Affiliation(s)
- Qiushi Tang
- Chinese Journal of Practical Surgery, China Medical University, 9 Nanjing South St., Shenyang 110001, China;
| | - Zhihong Wang
- Department of Thyroid Surgery, The First Hospital of China Medical University, 155 Nanjing Bei Street, Shenyang 110001, China
- Correspondence: ; Tel.: +86-24-83282191
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Wen W, Jiang H, Wen HY, Peng YL. Metastasis to the thyroid gland from primary breast cancer presenting as diffuse goiter: A case report and review of literature. World J Clin Cases 2022; 10:1106-1115. [PMID: 35127926 PMCID: PMC8790461 DOI: 10.12998/wjcc.v10.i3.1106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/28/2021] [Accepted: 12/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Metastasis to the thyroid gland (TM) from primary breast cancer is uncommon and usually presents as thyroid nodules; however, diffuse goiter without thyroid nodules is the first sign of TM in rare cases. Skip metastases (SMs) to the lymph nodes in breast cancer, defined as discontiguous higher-level metastases in the absence of lower levels of contiguous metastases, have been reported in the contralateral cervical area of the primary tumor site in rare cases.
CASE SUMMARY A 49-year-old previously healthy Chinese woman was diagnosed with right lateral invasive ductal carcinoma and underwent neoadjuvant chemotherapy treatment and bilateral mastectomy with axillary lymph node dissection. No malignancy of the left breast or axillary or distant metastases were identified preoperatively. However, enlarged left cervical lymph nodes were detected 36 mo after surgery, and rapidly enlarging thyroid glands without nodules were detected 42 mo after surgery. Fine-needle aspiration cytology was performed on the left cervical lymph nodes and left lobe of the thyroid, which were both revealed to contain metastases from the primary breast cancer. Additionally, the immunostaining profiles changed in the process of metastases. The patient was discharged with the NP (vinorelbine and cisplatin) regimen for subsequent treatment, and stable disease was determined when the curative effect was evaluated.
CONCLUSION Diffuse goiter may be the first sign of TM, and enlarged lymph nodes in the contralateral cervical area may be SMs of primary breast cancer.
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Affiliation(s)
- Wen Wen
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Heng Jiang
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68133, United States
| | - Hsin-Yu Wen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Lan Peng
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Wan Zainon WMN, Wan Abdul Rahman WF, Yahya MM, Mat Nawi NA, Suhaimi NS, Mat Nawi N. Aberrant intrathyroidal lymph node metastasis in classical papillary thyroid carcinoma. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00614-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In cases of papillary thyroid carcinoma (PTC), lymph nodes are a typical site of metastasis. Extrathyroidal tissue involvement in differentiated thyroid carcinoma causes the disease to progress and affects the patients’ treatment options. Papillary thyroid carcinoma (PTC) is the common type in differentiated thyroid carcinoma (DTC), the other type is follicular thyroid carcinoma (FTC). Ectopic sites, such as intrathyroidal lymph node invasion in classical papillary thyroid malignancy, are extremely uncommon. It can be difficult to detect an intrathyroidal lymph node (ITLN) during a histopathological test, but it is important to do so since it affects the stage of the disease and subsequent treatment.
Case presentation
We present the case of a 63-year-old woman who presented with multinodular goitre and underwent total thyroidectomy. She was diagnosed with aberrant intrathyroidal lymph node metastases during pathological testing, resulting in an upgrade in treatment. Owing to the exceptionally unusual ectopic position of lymph node metastasis, in this case, there is a risk of diagnostic and therapeutic misinterpretation. This patient was treated with high-dose radioactive iodine in view of lymph node metastases.
Conclusions
Identification of ITLN by imaging characteristics is sometimes difficult, being often an intraoperative discovery and histopathological correlation that lead to upstage the disease and alter the final management.
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9
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Wang Y, Zhou S, Yu B, Zhou P, Zhu J, Wei T, Li Z. Case Report and Review of Literature: Thyroid Metastases From Breast Carcinoma. Front Endocrinol (Lausanne) 2021; 12:631894. [PMID: 33776925 PMCID: PMC7994513 DOI: 10.3389/fendo.2021.631894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/15/2021] [Indexed: 02/05/2023] Open
Abstract
RATIONALE The thyroid is a rare site for distant metastases from breast carcinoma. The incidence of thyroid metastases in fine needle aspiration biopsy (FNAB) was less than 0.2%. PATIENT CONCERNS We report a case of 54-year-old woman with a history of breast carcinoma presented with diffuse scattered microcalcifications in thyroid and enlarged bilateral cervical lymph nodes detected on ultrasound (US). Physical examination of the patient revealed firm and enlarged thyroid lobes. DIAGNOSES FNAB and immunohistochemistry (IHC) of the thyroid lesion confirmed the thyroid metastases from breast cancer. INTERVENTIONS AND OUTCOMES Due to the comorbidities of breast carcinoma metastases to the right axillary, cervical lymph nodes and left chest wall, the patient received chemotherapy. After a follow-up of 19 months, the patient was alive without any new distant metastases. LESSONS Our case highlights that thyroid metastases should be considered in a patient combined with thyroid lesions and a history of breast carcinoma. IHC played an important role in differentiating thyroid metastases from primary thyroid cancer.
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Affiliation(s)
- Yichao Wang
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shengliang Zhou
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Boyang Yu
- Department of Sonography, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Zhou
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Jingqiang Zhu
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Wei
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
| | - Zhihui Li
- Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Zhihui Li,
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Pakuła J, Stępień T, Kuzdak K. Metastatic breast cancer in regrowth of thyroid lobe after subtotal thyroidectomy - case report. POLISH JOURNAL OF SURGERY 2020; 92:1-3. [PMID: 32945782 DOI: 10.5604/01.3001.0013.5723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Breast cancer is the most common malignant neoplasm among women. Metastases to the thyroid are relatively rare. Those lesions annunciate neoplasm dissemination in most cases. Metastatic breast cancer of thyroid lobe regrowth hasn't been described yet. In the article the authors present a case of a 66-year old women with isolated, metachronous breast cancer metastasis in regrowth of the right thyroid lobe. Resection of the right lobe with metastatic tumor was performed with a purpose of total recovery. Despite surgery, multiple bone metastases were detected a few months after. In conclusion, regrowth of the thyroid is a potential site of recurrence and metastasis. Therefore, the thyroid bed cannot be omitted in routine examination during and after oncological treatment.
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Affiliation(s)
- Joanna Pakuła
- Klinika Chirurgii Endokrynologicznej, Uniwersytet Medyczny w Łodzi
| | - Tomasz Stępień
- Klinika Chirurgii Endokrynologicznej, Uniwersytet Medyczny w Łodzi
| | - Krzysztof Kuzdak
- Klinika Chirurgii Endokrynologicznej, Uniwersytet Medyczny w Łodzi
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Rodrigo-Gómez L, Pardal-Refoyo JL, Batuecas-Caletrío Á. Prevalencia de tumores metastásicos en la glándula tiroides. Revisión sistemática y metanálisis. REVISTA ORL 2020. [DOI: 10.14201/orl.23207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: Los tumores metastásicos en la glándula tiroides complican el diagnóstico, el tratamiento y el pronóstico del paciente. El objetivo es conocer la prevalencia de las metástasis en la glándula tiroides referida en la literatura médica y los tumores primarios que con más frecuencia metastatizan en la glándula tiroides. Método: Se realizó una revisión bibliográfica sistemática en las bases de datos de PubMed, La Biblioteca Cochrane y Scopus. Los artículos seleccionados se dividieron en dos grupos, series clínicas de pacientes en los que se hallaron metástasis en tiroides (grupo A) y series de hallazgos de metástasis en tiroides en autopsias (grupo B). Se realizó metanálisis de prevalencia para cada grupo de artículos siguiendo el modelo de efectos aleatorios. Resultados: La prevalencia en cada grupo con su índice de confianza al 95% fue 0.00479 (0.002-0.007) para el grupo A y 0.0362 (0.014-0.059) para el grupo B. La prevalencia de metástasis halladas en autopsias fue 7,58 veces mayor que en los estudios clínicos. En el grupo A la edad media fue 60.82 y en el grupo B 57.20. En ambos grupos las metástasis halladas en tiroides fueron más frecuentes en el sexo femenino. La localización del tumor primario fue diferente en ambos grupos, en el grupo A fue el cáncer de riñón y en el grupo B el cáncer de mama. La variabilidad de la prevalencia de metástasis en tiroides en los diferentes artículos de ambos grupos hace que este estudio tuviese una alta heterogeneidad (índice I2 y Q). Los funnel plot de ambos grupos indicaron alto sesgo de publicación. Discusión: La diferente prevalencia entre series clínicas y autopsias puede implicar que la detección de metástasis en tiroides en la clínica está infradiagnosticada. La razón de esto podría ser que las metástasis intratiroideas se presentan de forma asintomática siendo diagnosticadas como hallazgo casual en autopsias. En otras ocasiones se presentan como un nódulo tiroideo años después del tumor primario, lo que condiciona el diagnóstico. Conclusiones: La prevalencia de metástasis en tiroides es superior en las series de autopsias que en series clínicas (hasta 6.67 veces más frecuente en nuestro estudio). Las metástasis intratiroideas probablemente están infradiagnosticadas por cursar sin clínica siendo diagnosticadas como hallazgo casual en autopsias. Los tumores primarios más frecuentes fueron el riñón (series clínicas) y la mama (series de autopsias).
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12
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Zhang YY, Xue S, Wang ZM, Jin MS, Chen ZP, Chen G, Zhang Q. Thyroid metastasis from breast cancer presenting with enlarged lateral cervical lymph nodes: A case report. World J Clin Cases 2020; 8:838-847. [PMID: 32149069 PMCID: PMC7052554 DOI: 10.12998/wjcc.v8.i4.838] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/01/2020] [Accepted: 01/11/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Secondary malignancy of the thyroid occurs infrequently and mainly originates from malignant tumors of the kidney, gastrointestinal tract, lungs, breast, and skin. The correct diagnosis is important but difficult. Importantly, there are major differences in the treatment of primary and metastatic thyroid cancer, which has a significant impact on prognosis and survival. Therefore, how to diagnose thyroid metastasis (TM) correctly before surgery is a major concern for surgeons.
CASE SUMMARY We report a 38-year-old woman who presented with palpable cervical lymph nodes after breast cancer (BC) surgery 2 years ago. Ultrasonography and computed tomography revealed thyroid nodules with irregular margins and enlarged cervical lymph nodes. Biopsy was performed for the right largest cervical lymph node, and immunohistochemical analysis revealed negativity for thyroglobulin, estrogen receptor, and progestin receptor and positive for human epidermal growth factor receptor 2. The diagnosis was TM from BC with cervical lymph node metastasis. Total thyroidectomy with bilateral central and lateral neck lymph node dissection was performed. After a 5-mo follow-up, no recurrence or novel distant metastasis was identified.
CONCLUSION TM from BC is a rare secondary malignancy. Broad differential diagnosis by biopsy and immunohistochemical analysis needs to be considered.
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Affiliation(s)
- Yan-Yan Zhang
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Shuai Xue
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zheng-Min Wang
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Mei-Shan Jin
- Department of Pathology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zhong-Ping Chen
- Department of Radiology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Guang Chen
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Qiang Zhang
- Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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Multifocal Metastatic Breast Carcinoma to the Thyroid Gland Histologically Mimicking C Cell Lesions. Case Rep Pathol 2019; 2019:9890716. [PMID: 30956833 PMCID: PMC6431456 DOI: 10.1155/2019/9890716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/21/2019] [Indexed: 12/22/2022] Open
Abstract
The thyroid gland is an uncommon site of metastatic disease. Renal cell carcinoma is the most common primary source, while metastasis from breast carcinoma is very rare. However, given that thyroid nodules are more common in women, and women with a history of breast cancer are at higher risk of developing thyroid cancer, the possibility of metastatic breast carcinoma must be considered when evaluating a thyroid nodule. We present the case of a 67-year-old woman who presented with dysphonia and dysphagia secondary to multinodular goiter and was found to have multifocal metastatic breast carcinoma in her surgical resection specimen. The histologic appearance focally mimicked C cell hyperplasia and medullary thyroid carcinoma, so immunohistochemistry was critical for establishing the diagnosis. Metastasis to the thyroid should always be included in the differential diagnosis for a thyroid nodule in a patient with a history of previous malignancy.
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